FMRI

Migraine is a very common and disabling condition that affects 20% of population, mainly young individuals in a working productive age. Commonly, migraine is a pain condition that occurs sporadically, several times a month; In some patients this process may increase in frequency and appear daily, in a chronic way. These patients are at risk of developing a medication overuse, with an evident worsening of their quality of life and health. The phenomenon of medication overuse is an intriguing event and its etiopathogenesis is not well established, although it is theorized that a hypometabolic orbitofrontal cortex, similar to what is found in patients abusing other substances, could be a possible explanation. In this study we sought to perform a f-MRI, using the appropriate paradigms (Sternberg, N-back and Gambling Tasks) that have never been employed in this setting to 2 groups of migraine patients; patients with sporadic migraine and with chronic migraine and medication overuse, with the objective of demonstrating a frontal dysfunction (dorsolateral and orbitofrontal). As a secondary objective we sought to investigate whether this hypofunctionality of the OF cortex is a bad prognosis sign regarding migraine course or not. To this end, we will follow these patients for a year by means of a migraine calendar, a depression inventory and a quality of life questionnaire. The confirmation of frontal dysfunction in patients with chronic migraine and medication overuse is interesting in understanding the mechanism of disease and in planning new therapeutical interventions.